A common requirement in many surgical procedures is the resection or bypass of a diseased organ. Often the diseased section is a part of a tubular structure (e.g. artery, bowel, esophagus) and after the resection it is required to reattach the resulting two healthy ends. This procedure is termed as anastomosis and is a fairly easy task to perform in the setting of an open surgery. However, in minimally invasive surgery (MIS) where the procedure is performed through small incisions in the patient's skin, anastomosis is an extremely difficult skill to learn and execute. Typical anastomosis time in a MIS procedure ranges anywhere from half an hour up to two hours. Needless to say, the long anastomosis time has a negative impact on the patient due to increased anesthesia requirement. For the surgeon, laparoscopic anastomosis is extremely difficult to learn and perform, and is very fatiguing in nature. Increased anastomosis time is also a burden on the healthcare provider as it takes up valuable operating room time and adds to the personnel cost.
U.S. Pat. No. 6,358,258 issued to Arcia et al. discloses an anastomosis device that utilizes multiple flexible needles (designed of Nitinol material) that are deployed through multiple curved guide channels. The design utilizes multiple push rods for actuation and is suitable for end-side type anastomosis.
U.S. Pat. No. 7,029,481 issued to Burdulis et al. discloses an anastomosis device that utilizes multiple needles that are simultaneously pierced through the tissue using a pneumatic cylinder. The needles latch onto small crimps on the opposite end and pull the sutures through the tissue upon retraction. The other end of the device utilizes multiple flexible needles deployed using curved channels and multiple push rods. The design needs custom needles as the sutures are attached to the distal tip of the needle as opposed to the proximal end found in conventional sutures.
U.S. Patent Application US2008/0275472, to Yossepowitch et al. discloses an anastomosis device that utilizes multiple needle deployment through the use of flexible needle and curved guide channels. The design utilizes multiple push rods and requires custom needles to function. Even though the two ends of the design are attached through a flexible coupler, the design lacks a good suture management scheme and will suffer from suture tangling. Similar to U.S. Pat. No. 7,029,481, the design needs custom needles as the sutures are attached to the distal tip of the needle as opposed to the proximal end found in conventional sutures.
Thus, there is a need for an automated/assisted laparoscopic anastomosis device that can reduce procedure time and operating costs. The device will also be of interest to the surgeons as it would minimize the dependence on a surgeon's dexterity and experience and will reduce the learning curve of this complex task.